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General NPI Number Information
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NPI Number | 1831200377
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Entity Type | Organization
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Legal Business Name | ALBERTS & LAHEY
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2309 PARK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4317
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Country | US
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Telephone | 904-389-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 PARK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4317
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Country | US
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Telephone | 904-389-7337
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. CAROL DEVAULT LAHEY
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Credential | PH.D.
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Telephone | 904-389-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6352
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License Number State | FL
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